Chronic Onset Form of Anti-HMG-CoA Reductase Myopathy

  • Noel Lorenzo Villalba Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasboug, France
  • Emmanuel Andrés Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasboug, France
  • Alain Meyer Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, France

Abstract

We report a case of anti-HMGCR myopathy mimicking limb-girdle muscular dystrophy in a 27-year-old male patient with no history of statin intake and presenting with a chronic onset form over 3 years. Treatment with prednisone and methotrexate was initiated with an insufficient response, so intravenous immunoglobulin was added. One year after initial treatment was started, as levels of creatine kinase (CK) were >1000 U/l, treatment with rituximab was added. Despite a 3-year delay before treatment, muscle strength improved even though CK levels remain elevated.

VIEW THE ENTIRE ARTICLE

References

  • Tiniakou E, Pinal-Fernandez I, Lloyd TE, Albayda J, Paik J, Werner JL, et al. More severe disease and slower recovery in younger patients with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase-associated autoimmune myopathy. Rheumatology (Oxford) 2017;56(5):787–794.
  • Allenbach Y, Mammen AL, Benveniste O, Stenzel W, Immune-Mediated Necrotizing Myopathies Working Group. 224th ENMC International Workshop: Clinico-sero-pathological classification of immune-mediated necrotizing myopathies Zandvoort, The Netherlands, 14–16 October 2016. Neuromuscul Disord 2018;28(1):87–99.
  • Rider LG, Koziol D, Giannini EH, Jain MS, Smith MR, Whitney-Mahoney K, et al. Validation of manual muscle testing and a subset of eight muscles for adult and juvenile idiopathic inflammatory myopathies. Arthritis Care Res 2010;62(4):465–472.
  • Mammen AL. Statin-associated autoimmune myopathy. N Engl J Med 2016;374(7):664–669.
  • llenbach Y, Drouot L, Rigolet A, Charuel JL, Jouen F, Romero NB, et al. Anti-HMGCR autoantibodies in European patients with autoimmune necrotizing myopathies: inconstant exposure to statin. Medicine (Baltimore) 2014;93:150–157.
  • Thompson R, Straub V. Limb-girdle muscular dystrophies - international collaborations for translational research. Nat Rev Neurol 2016;12(5):294–309.
  • Tansley SL, Li D, Betteridge ZE, McHugh NJ. The reliability of immunoassays to detect autoantibodies in patients with myositis is dependent on autoantibody specificity. Rheumatology (Oxford) 2020;59(8):2109–2114.
  • Meyer A, Troyanov Y, Drouin J, Oligny-Longpré G, Landon-Cardinal O, Hoa S, et al. Statin-induced anti-HMGCR myopathy: successful therapeutic strategies for corticosteroid-free remission in 55 patients. Arthritis Res Ther 2020;22(1):5.
  • Werner JL, Christopher-Stine L, Ghazarian SR, Pak KS, Kus JE, Daya NR, et al. Antibody levels correlate with creatine kinase levels and strength in anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase-associated autoimmune myopathy. Arthritis Rheum 2012;64:4087–40893.
  • Published: 2021-06-08

    Issue: 2021: Vol 8 No 6 (view)

    Section: Articles

    How to cite:
    1.
    Lorenzo Villalba N, Andrés E, Meyer A. Chronic Onset Form of Anti-HMG-CoA Reductase Myopathy. EJCRIM 2021;8 doi:10.12890/2021_002672.

    Most read articles by the same author(s)

    << < 1 2